What does it mean to have diabetes?If you have just been diagnosed with diabetes, you are not alone! Having diabetes means that your body's hormone, insulin, is not doing its job. Insulin is needed to properly use the food that you eat for energy. Most of the food that you eat is broken down into glucose and other simple sugars. Normally, as newly arrived glucose enters the blood stream; your body releases insulin from the pancreas, and puts the glucose into your cells to use as fuel. If you lack insulin, or your insulin is unable to function properly, the newly arrived glucose cannot be stored and will remain in your blood stream. Your blood glucose levels (also referred to as blood sugar levels) will then become elevated. These abnormally high levels, left untreated, can eventually cause damage to your eyes, heart, nerves and kidneys.
What are the different types of diabetes?There are several types of diabetes. The most common are type 1 and type 2. In type 1, the pancreas makes little or no insulin. Individuals with type 1 need insulin shots in order to stay alive. Type 1 can occur at any age, but is usually seen in children and young adults. With type 2 diabetes, the pancreas produces some insulin, but the amount is either not enough or is not effective, because the body's cells are resistant to it. Some individuals with type 2 diabetes need insulin to regulate their blood glucose, while others respond well to diet therapy and exercise alone, or a combination of diet, exercise and oral medication. Type 2 can occur at any age, but is most often seen after age 40.
What causes diabetes?The exact cause of diabetes is unknown. Heredity may play a role in developing both types, but is most often associated with type 2. Eating sweets does not cause diabetes, but must be limited to help control it. Being overweight, certain medications (ex: thyroid hormone, glucocorticoids, etc.) and emotional and physical stress related to medical conditions such as pregnancy, illness and surgery, can play a role in its development. Also, for reasons not yet known, certain ethnic groups tend to have a higher incidence of type 2.
What are the most common signs and symptoms of diabetes?The warning signs of diabetes include:
- Frequent urination Blurred vision
- Unusual thirst
- Numbness or tingling in hands and feet
- Intense hunger Frequent infections
- Extreme fatigue Irritability
- Slow healing cuts/wounds
Can diabetes be Cured?If treated properly, your blood glucose can go down to normal levels, but diabetes will always be part of your life. Millions of individuals live healthy and active lives with diabetes, and you can too! Make an effort to be involved in your treatment and learn all that you can about diabetes.
How is diabetes treated?Diabetes is a serious condition. Although not curable, it is treatable. Those who do best are the individuals who take an active role in their own treatment. It is important to know how to manage your blood glucose levels. Treatment includes healthy, balanced eating, exercise, regular blood glucose testing and sometimes insulin injections and medication.
What makes for a diabetes-friendly diet?There are no bad foods. For many years, individuals with diabetes were told to avoid foods containing sugar. Fortunately, we now know more about how diabetes works and today's diabetic diets are creative, healthy and allow for great variety. Although possible, few people manage to keep their blood glucose within a target range using diet alone. However, even if you need to take oral medication and/or insulin to control your blood glucose levels, diet will always be an important part of your treatment. What you eat, when you eat it, and how much food you eat, affects your blood glucose levels. The closer you keep your blood glucose levels to normal, the lower your risk of developing serious eye, kidney and nerve damage. Let's take a look at how different foods affect your diabetes: Carbohydrates Starches (pastas, rice, bread, cake, potatoes, corn, etc.), fruit and milk are high in carbohydrates. Once in your body, they break down into your cells' preferred form of energy--glucose. Insulin is needed to help your cells take in the glucose. With diabetes, your insulin cannot do this task properly. A healthy balanced diet helps you schedule your carbohydrate intake so that your cells can get the glucose that they need. Consuming too many carbohydrate-containing foods can raise your blood glucose way above normal; eating too few, can hurt your body by denying it the high quality energy that it needs. Balancing your carbohydrate intake is an important part of your diabetes treatment. Protein Protein is found in milk, meats, cheeses, eggs and nuts and tofu. It builds and repairs muscles, skin and cells in your body. During digestion, protein breaks down into amino acids which can, if necessary, be converted to glucose. Your body's cells, however, prefer using glucose from carbohydrates for energy. Fat Fat (oils, margarine, butter, lard, etc.) supplies needed energy, carries fat-soluble vitamins A, D, E and K in your body, and helps to maintain healthy skin. It adds to the flavour and texture of food, but should be limited. Fat is high in calories and too much fat in your diet can increase your risk of heart and blood vessel disease.
What special eating habits should diabetics practice?The timing of your meals is as important as what you eat. The more you eat at one meal, the more insulin you will need to utilise the energy from the breakdown of those foods. If you eat smaller portions throughout your day, you will not need as much insulin to bring down your blood sugar. Here are some recommendations:
- Eat at least 3 times during your day. Many people enjoy 3 small meals and two snacks.
- Eat each meal and snack at about the same time every day.
- Do not skip meals. Carry some food with you if you think that you will be delayed.
- Be mindful of meal portion sizes appropriate for your particular needs. Meal plans are individualised to provide you with the proper balance of carbohydrates, protein and fat, along with vitamins, minerals, fibre and other nutrients needed to keep you healthy. A registered dietician is especially trained to design a diet that best suits your medical needs and lifestyle.
Exercising with diabetes: are there special considerations diabetics should take?Exercise is a powerful tool for controlling your diabetes. It helps your cells take in glucose and aids in keeping your blood sugar at normal levels. Ask your doctor or Diabetic Nurse Practitioner about the types of activity that meet your physical needs. It is recommended that you exercise for at least 20 minutes, 3-4 times each week. Remember to begin slowly if you haven't exercised in a long time. Even 5 minutes each day can make a big difference in your health and your blood glucose levels.
The why’s and how’s of measuring blood glucose levelsTesting your own blood glucose level helps both you and your doctor see if your treatment plan is working for you. With the use of a glucose meter it is very simple to do. All you need is a small drop of blood from your finger. Insert the strip into the meter and place the blood on the strip and the glucose meter will then measure your blood glucose levels. The normal range for blood glucose is between (4.0 – 8.0mmol/L). Blood glucose levels will go up immediately following a meal, but should return to normal levels within 2 hours. Fasting blood glucose levels of 7mmol/L or higher, is diagnosed as diabetes.
What is the purpose of urine testing in controlling diabetes?With diabetes, your blood sugar can go way too high. This can occur if you overeat, take too little insulin, become sick, or are under significant stress. Under these conditions, or for any other reason your body cannot get enough glucose for energy it will switch to using body fats. The byproducts of fat breakdown are chemicals called ketones and are detectable in the blood and urine. Ketones can be extremely dangerous, they can make you extremely thirsty, cause you to throw up, experience abdominal pains, have difficulty breathing and put you into a coma. To detect the presence of ketones, you should test your urine. Test strips for this purpose are available from pharmacies. Be sure to test your urine if you experience the symptoms listed above and/or have a blood glucose level of over 13 mmol/L. If you find that your urine tests positive for ketones, call your doctor immediately.
What role do oral medications play in managing diabetes?You may need to take diabetes pills as part of your treatment plan. These pills work best when used with a healthy diet and regular exercise. There are many types of pills available and they work in a variety of ways. Some inhibit the release of glucose from your liver, slow the absorption of glucose in your gut and enhance the absorption of glucose in other parts of your body. Others stimulate your pancreas to produce additional insulin and help your cells respond better to available insulin. Your doctor will prescribe the ones that are best suited to your needs.
All about insulinIn certain types of diabetes, there is not enough insulin available. Insulin shots must then be taken which help glucose enter into the cells. The thought of giving yourself a shot can be a tough one, but with technical advances in the design and development of a wide range of injecting “pens”, know that millions of individuals are now giving themselves insulin shots with great ease. Insulin attaches to the outside of most of your body cells and allows glucose to enter. Currently, it must be injected and cannot be put into pill form; your digestive enzymes would destroy it before it could begin to lower your blood glucose levels. Research, however, is ongoing regarding new ways to take insulin. What are the different types of insulin? There are several types of insulin. They are classified as rapid-acting, intermediate-acting, and long-acting. You may be asked to combine these types depending on your needs. Your Diabetic Nurse Practitioner is a great resource for helping you set up a régime that works for you. Rapid-acting and short-acting insulin begin to act very quickly after you inject them and last a short time. They are usually taken to prevent an abnormal rise in glucose levels following meals. Intermediate and long-acting insulin has a gradual and longer lasting effect on blood glucose levels. There are two popular kinds of insulin; purified pork insulin and human insulin. Purified pork insulin acts much like the insulin made by the human body. Human insulin is not actually from humans, but is developed in a laboratory and is considered the most pure. What is the proper way to handle insulin? Insulin should be stored in a refrigerator, but once opened, can be stored at room temperature for easy access and comfort. Room temperature insulin usually feels more comfortable when injected and remains stable for 30 days after opening. When traveling, do not check in your insulin with your bags. Luggage can be lost, and storage compartments are often extremely cold. Inspect the expiration date on your insulin. Do not use it beyond this date. Examine your insulin before using. Do not use it if the color appears abnormal or the insulin does not mix well. It is recommended that you dispose of your needles in a sharps container made especially for this purpose. Your doctor will decide which type of insulin is best for you and make sure that you learn the correct techniques for using it.
What are the most common problems diabetics run into?High blood glucose (hyperglycemia): There may be times when your blood sugar (glucose) levels go too high. This can happen when you are ill or under stress, eat too much, or have too little insulin in your blood. High blood glucose can cause headaches, blurry vision, frequent urination, increased thirst, and dry itchy skin. Ketones: Test your urine for ketones if you experience a blood glucose reading of over 240 mg/dl (13 mmol/L), are sick, or have any of the symptoms listed above. Be sure to drink lots of water if you are urinating often. It is very dangerous to become dehydrated. If your urine tests positive for ketones, contact your doctor immediately. Low blood glucose: There may also be times when your blood glucose will be too low. This can be caused by taking too much insulin, not eating enough, drinking alcohol on an empty stomach, or exercising for an extended period. When your blood glucose is low, you may become shaky, feel tired, experience intense hunger, and become confused or nervous. It is important that you treat low blood glucose immediately. Test your blood glucose if you feel that it is too low. If it is less than 70mg/dl (less than 4 mmol/L) follow the 15/15 rule: eat or drink something with the equivalent of 15 grams of carbohydrate and then wait 15 minutes before retesting your blood sugar. The following servings contain 15 grams of carbohydrate: ½ cup apple or orange juice, or ½ - 3/4 cup regular carbonated beverage (not diet), or 5 Super C sweets Infections: Infections are common in people with diabetes. The first sign of an oncoming infection may be elevated blood glucose. Other signs of infection include: pain, swelling, fever, redness, a feeling of warmth in a certain area, and a discharge. They can be very serious and can occur without any open cut or injury. Call your doctor if you suspect that you have an infection. Circulation: High blood glucose levels over an extended period of time can affect your blood vessels. This may lead to sexual problems such as impotence, cause kidney and vision problems and encourage the development of skin ulcers which, if left untreated, may lead to amputation. Individuals with diabetes are also at greater risk for heart attacks, strokes and other cardiovascular diseases. Be sure to see both your physician and eye doctor regularly. Dental problems: When your blood glucose is high, it is not unusual to get a mouth infection. High blood glucose levels encourage bacterial growth. Brush your teeth at least two times each day. Be aware of any bleeding or gum soreness. Schedule regular dental examinations and be sure to tell your dentist that you have diabetes. Try to schedule your dental appointments after mealtimes to lower your risk of low blood sugar caused by limiting your food intake following dental work. Foot Problems: Decreased feeling in your feet can make it difficult to know if your feet have been injured in any way. Early treatment of any foot injury can prevent serious complications, such as infection which can lead to amputation. To prevent foot problems, make certain that you wear shoes and socks that fit properly and change your shoes at least once during the day. Check your feet every time you remove your shoes. Look for redness, which can occur when shoes do not fit properly. Also look for cracks, cuts, bruises, etc. Discuss with your doctor or podiatrist the best way to care for your feet, cut your nails, and treat calluses.